IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy
BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidin...
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| Veröffentlicht in: | Gut 2022-09, Vol.71 (Suppl 2), p.A107-A108 |
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| description | BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidine-based conscious sedation regime and identify risk factors of hemodynamic instability.MethodsA retrospective study was conducted by reviewing the endoscopy record of patients receiving a Dexmedetomidine-based conscious sedation regime for gastrointestinal endoscopy in Tuen Mun Hospital from July 2019 to June 2021. All procedures were performed in the endoscopy room. The titration of sedative agents was determined by in-charge endoscopists. Dexmedetomidine was administered as loading intravenous (IV) infusion (0.5–1mcg/kg) over 10 minutes followed by maintenance IV infusion (0.2–1mcg/kg/hour). Fentanyl was also prescribed as an IV infusion or IV bolus for analgesic effect. Bolus IV Midazolam may be given if necessary to achieve a desirable level of sedation. Blood pressure was recorded at least every 5 minutes while continuous cardiac, oximeter and capnography monitoring were applied to all patients.Results160 endoscopic procedures were performed in 141 patients (80 males & 61 females), with a mean age of 59.6 ± 19 years old (range 16–93), in this analysis (IDDF2022-ABS-0012 Table 1). Hemodynamic instability (defined as systolic blood pressure |
| doi_str_mv | 10.1136/gutjnl-2022-IDDF.139 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_bmj_j</sourceid><recordid>TN_cdi_proquest_journals_2711021646</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2711021646</sourcerecordid><originalsourceid>FETCH-LOGICAL-b696-a61f8109bd66584e96e5273e55e684c86826916a1944f3175f7bea7ae28270773</originalsourceid><addsrcrecordid>eNpFkE1Lw0AQQBdRsFb_gYcFz1t3N8l-HGtrtVDw0N7DJpmEhGS3ZhOwNy_-UX-JGyt4GgbeDI-H0D2jC8Yi8ViNQ2NbwinnZLtebxYs0hdoxmKhSMSVukQzSpkkiYz1NbrxvqGUKqXZDI0T_3u4fNqTQPHvz6-9KWE4YVfiAj46KGBwXV3UFkhmPBQ4d9bntRs9DpsZamdxD1XdAa4tPvaudbYKWGX80LvaDuCH2poWgy2cz93xdIuuStN6uPubc3TYPB9Wr2T39rJdLXckE1oQI1ipGNVZIUSiYtACEi4jSBIQKs6VUFxoJgzTcVxGTCalzMBIA1xxSaWM5ujh_DY4vY_BIm3c2AcTn3LJGOVMxCJQ9ExlXfMPMJpObdNz23RKlE6t0tA2-gFwmG7i</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2711021646</pqid></control><display><type>article</type><title>IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy</title><source>PubMed Central</source><creator>Cheng, Ka-Shing ; Kin-Kong Li, Michael ; Sze, Ka-Kin ; Fong, Man-Chung</creator><creatorcontrib>Cheng, Ka-Shing ; Kin-Kong Li, Michael ; Sze, Ka-Kin ; Fong, Man-Chung</creatorcontrib><description>BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidine-based conscious sedation regime and identify risk factors of hemodynamic instability.MethodsA retrospective study was conducted by reviewing the endoscopy record of patients receiving a Dexmedetomidine-based conscious sedation regime for gastrointestinal endoscopy in Tuen Mun Hospital from July 2019 to June 2021. All procedures were performed in the endoscopy room. The titration of sedative agents was determined by in-charge endoscopists. Dexmedetomidine was administered as loading intravenous (IV) infusion (0.5–1mcg/kg) over 10 minutes followed by maintenance IV infusion (0.2–1mcg/kg/hour). Fentanyl was also prescribed as an IV infusion or IV bolus for analgesic effect. Bolus IV Midazolam may be given if necessary to achieve a desirable level of sedation. Blood pressure was recorded at least every 5 minutes while continuous cardiac, oximeter and capnography monitoring were applied to all patients.Results160 endoscopic procedures were performed in 141 patients (80 males & 61 females), with a mean age of 59.6 ± 19 years old (range 16–93), in this analysis (IDDF2022-ABS-0012 Table 1). Hemodynamic instability (defined as systolic blood pressure <90mmHg and/or heart rate <50bpm) happened in 75 procedures (47%): hypotension alone (24.4%, n=39), bradycardia alone (16.3%, n=26), both hypotension and bradycardia (6.3%, n=10). All hemodynamic instability cases were reversed readily by the following methods: IV fluid challenge and/or reducing Dexmedetomidine infusion rate (88%, n=66), IV Ephedrine (9.3%, n=7) and IV Atropine (2.7%, n=2). Oxygen desaturation (SpO2 85–90%) occurred in 4 cases (2.5%), all of which were corrected successfully by supplementary oxygen. No early termination of procedure due to struggle or sedation-related adverse event was reported. In multivariate analysis, age >65 years old was significantly associated with hemodynamic instability (IDDF2022-ABS-0012 Table 2).Abstract IDDF2022-ABS-0012 Table 1Details of endoscopic procedures (Total number = 160)1. Type of procedures, n (%) Double-ballon enteroscopy (DBE) 57 (35.6%) DBE-assisted endoscopic retrograde cholangiopancreatography 29 (18.1%) Motorized spiral enteroscopy 22 (13.8%) Endoscopic submucosal dissection 52 (32.5%) 2. Procedure time, mean±s.d. (range), min 153.8 ± 84.7 (33–347) 3. Dosage of Dexmedetomidine, mean±s.d., mcg 102 ± 35 4. Dosage of Fentanyl, mean±s.d., mcg 141.5 ± 58.6 5. Procedures with use of Midazolam, n (%) 122 (76.3%) 6. Dosage of Midazolam, mean±s.d.,mg 4 ± 2.1 Abstract IDDF2022-ABS-0012 Table 2Multivariable analysis for independent predictors of hemodynamic instability Odd Ratio 95% Confidence Interval P value Age > 65 years old 1.975 1.353- 2.621 0.036 Male gender 1.212 0.763–1.601 0.227 Use of Dormicum 0.356 0.080–1.581 0.175 Presence of stage 4/5 chronic kidney disease 0.701 0.089–5.525 0.736 Presence of obstructive jaundice/cirrhosis 0.326 0.035–3.026 0.324 Presence of cardiac disease 1.382 0.154–12.424 0.773 Body Mass Index >30kg/m2 1.477 0.124–17.539 0.757 Baseline Mean arterial pressure 0.992 0.978–1.023 0.132 Baseline heart rate 0.986 0.941–1.045 0.317 Use of anti-hypertensive/anti-arrhythmic agents 7.926 0.421–32.721 0.680 ConclusionsDexmedetomidine-based conscious sedation regime is a safe option for prolonged gastrointestinal endoscopy. Cautious use is recommended in the elderly.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2022-IDDF.139</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Analgesics ; Anesthesia ; Antihypertensives ; Atropine ; Blood pressure ; Body mass index ; Bradycardia ; Carbon dioxide ; Cardiac arrhythmia ; Cirrhosis ; Clinical Gastroenterology ; Coronary artery disease ; Dosage ; Endoscopy ; Ephedrine ; Fentanyl ; Heart diseases ; Heart rate ; Hemodynamics ; Hypotension ; Instability ; Intravenous administration ; Jaundice ; Kidney diseases ; Liver cirrhosis ; Midazolam ; Multivariate analysis ; Oxygen ; Patients ; Risk factors ; Titration</subject><ispartof>Gut, 2022-09, Vol.71 (Suppl 2), p.A107-A108</ispartof><rights>Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27928,27929</link.rule.ids></links><search><creatorcontrib>Cheng, Ka-Shing</creatorcontrib><creatorcontrib>Kin-Kong Li, Michael</creatorcontrib><creatorcontrib>Sze, Ka-Kin</creatorcontrib><creatorcontrib>Fong, Man-Chung</creatorcontrib><title>IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy</title><title>Gut</title><addtitle>Gut</addtitle><description>BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidine-based conscious sedation regime and identify risk factors of hemodynamic instability.MethodsA retrospective study was conducted by reviewing the endoscopy record of patients receiving a Dexmedetomidine-based conscious sedation regime for gastrointestinal endoscopy in Tuen Mun Hospital from July 2019 to June 2021. All procedures were performed in the endoscopy room. The titration of sedative agents was determined by in-charge endoscopists. Dexmedetomidine was administered as loading intravenous (IV) infusion (0.5–1mcg/kg) over 10 minutes followed by maintenance IV infusion (0.2–1mcg/kg/hour). Fentanyl was also prescribed as an IV infusion or IV bolus for analgesic effect. Bolus IV Midazolam may be given if necessary to achieve a desirable level of sedation. Blood pressure was recorded at least every 5 minutes while continuous cardiac, oximeter and capnography monitoring were applied to all patients.Results160 endoscopic procedures were performed in 141 patients (80 males & 61 females), with a mean age of 59.6 ± 19 years old (range 16–93), in this analysis (IDDF2022-ABS-0012 Table 1). Hemodynamic instability (defined as systolic blood pressure <90mmHg and/or heart rate <50bpm) happened in 75 procedures (47%): hypotension alone (24.4%, n=39), bradycardia alone (16.3%, n=26), both hypotension and bradycardia (6.3%, n=10). All hemodynamic instability cases were reversed readily by the following methods: IV fluid challenge and/or reducing Dexmedetomidine infusion rate (88%, n=66), IV Ephedrine (9.3%, n=7) and IV Atropine (2.7%, n=2). Oxygen desaturation (SpO2 85–90%) occurred in 4 cases (2.5%), all of which were corrected successfully by supplementary oxygen. No early termination of procedure due to struggle or sedation-related adverse event was reported. In multivariate analysis, age >65 years old was significantly associated with hemodynamic instability (IDDF2022-ABS-0012 Table 2).Abstract IDDF2022-ABS-0012 Table 1Details of endoscopic procedures (Total number = 160)1. Type of procedures, n (%) Double-ballon enteroscopy (DBE) 57 (35.6%) DBE-assisted endoscopic retrograde cholangiopancreatography 29 (18.1%) Motorized spiral enteroscopy 22 (13.8%) Endoscopic submucosal dissection 52 (32.5%) 2. Procedure time, mean±s.d. (range), min 153.8 ± 84.7 (33–347) 3. Dosage of Dexmedetomidine, mean±s.d., mcg 102 ± 35 4. Dosage of Fentanyl, mean±s.d., mcg 141.5 ± 58.6 5. Procedures with use of Midazolam, n (%) 122 (76.3%) 6. Dosage of Midazolam, mean±s.d.,mg 4 ± 2.1 Abstract IDDF2022-ABS-0012 Table 2Multivariable analysis for independent predictors of hemodynamic instability Odd Ratio 95% Confidence Interval P value Age > 65 years old 1.975 1.353- 2.621 0.036 Male gender 1.212 0.763–1.601 0.227 Use of Dormicum 0.356 0.080–1.581 0.175 Presence of stage 4/5 chronic kidney disease 0.701 0.089–5.525 0.736 Presence of obstructive jaundice/cirrhosis 0.326 0.035–3.026 0.324 Presence of cardiac disease 1.382 0.154–12.424 0.773 Body Mass Index >30kg/m2 1.477 0.124–17.539 0.757 Baseline Mean arterial pressure 0.992 0.978–1.023 0.132 Baseline heart rate 0.986 0.941–1.045 0.317 Use of anti-hypertensive/anti-arrhythmic agents 7.926 0.421–32.721 0.680 ConclusionsDexmedetomidine-based conscious sedation regime is a safe option for prolonged gastrointestinal endoscopy. Cautious use is recommended in the elderly.</description><subject>Analgesics</subject><subject>Anesthesia</subject><subject>Antihypertensives</subject><subject>Atropine</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Bradycardia</subject><subject>Carbon dioxide</subject><subject>Cardiac arrhythmia</subject><subject>Cirrhosis</subject><subject>Clinical Gastroenterology</subject><subject>Coronary artery disease</subject><subject>Dosage</subject><subject>Endoscopy</subject><subject>Ephedrine</subject><subject>Fentanyl</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Hypotension</subject><subject>Instability</subject><subject>Intravenous administration</subject><subject>Jaundice</subject><subject>Kidney diseases</subject><subject>Liver cirrhosis</subject><subject>Midazolam</subject><subject>Multivariate analysis</subject><subject>Oxygen</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Titration</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpFkE1Lw0AQQBdRsFb_gYcFz1t3N8l-HGtrtVDw0N7DJpmEhGS3ZhOwNy_-UX-JGyt4GgbeDI-H0D2jC8Yi8ViNQ2NbwinnZLtebxYs0hdoxmKhSMSVukQzSpkkiYz1NbrxvqGUKqXZDI0T_3u4fNqTQPHvz6-9KWE4YVfiAj46KGBwXV3UFkhmPBQ4d9bntRs9DpsZamdxD1XdAa4tPvaudbYKWGX80LvaDuCH2poWgy2cz93xdIuuStN6uPubc3TYPB9Wr2T39rJdLXckE1oQI1ipGNVZIUSiYtACEi4jSBIQKs6VUFxoJgzTcVxGTCalzMBIA1xxSaWM5ujh_DY4vY_BIm3c2AcTn3LJGOVMxCJQ9ExlXfMPMJpObdNz23RKlE6t0tA2-gFwmG7i</recordid><startdate>20220902</startdate><enddate>20220902</enddate><creator>Cheng, Ka-Shing</creator><creator>Kin-Kong Li, Michael</creator><creator>Sze, Ka-Kin</creator><creator>Fong, Man-Chung</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20220902</creationdate><title>IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy</title><author>Cheng, Ka-Shing ; Kin-Kong Li, Michael ; Sze, Ka-Kin ; Fong, Man-Chung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b696-a61f8109bd66584e96e5273e55e684c86826916a1944f3175f7bea7ae28270773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analgesics</topic><topic>Anesthesia</topic><topic>Antihypertensives</topic><topic>Atropine</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Bradycardia</topic><topic>Carbon dioxide</topic><topic>Cardiac arrhythmia</topic><topic>Cirrhosis</topic><topic>Clinical Gastroenterology</topic><topic>Coronary artery disease</topic><topic>Dosage</topic><topic>Endoscopy</topic><topic>Ephedrine</topic><topic>Fentanyl</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Hemodynamics</topic><topic>Hypotension</topic><topic>Instability</topic><topic>Intravenous administration</topic><topic>Jaundice</topic><topic>Kidney diseases</topic><topic>Liver cirrhosis</topic><topic>Midazolam</topic><topic>Multivariate analysis</topic><topic>Oxygen</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Titration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Ka-Shing</creatorcontrib><creatorcontrib>Kin-Kong Li, Michael</creatorcontrib><creatorcontrib>Sze, Ka-Kin</creatorcontrib><creatorcontrib>Fong, Man-Chung</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Ka-Shing</au><au>Kin-Kong Li, Michael</au><au>Sze, Ka-Kin</au><au>Fong, Man-Chung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><date>2022-09-02</date><risdate>2022</risdate><volume>71</volume><issue>Suppl 2</issue><spage>A107</spage><epage>A108</epage><pages>A107-A108</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>BackgroundDexmedetomidine is a potent agent to induce deep conscious sedation, but there is a lack of safety data on its use for prolonged endoscopic procedures like endoscopic submucosal dissection and device-assisted enteroscopy. This study would illustrate the safety profile of the Dexmedetomidine-based conscious sedation regime and identify risk factors of hemodynamic instability.MethodsA retrospective study was conducted by reviewing the endoscopy record of patients receiving a Dexmedetomidine-based conscious sedation regime for gastrointestinal endoscopy in Tuen Mun Hospital from July 2019 to June 2021. All procedures were performed in the endoscopy room. The titration of sedative agents was determined by in-charge endoscopists. Dexmedetomidine was administered as loading intravenous (IV) infusion (0.5–1mcg/kg) over 10 minutes followed by maintenance IV infusion (0.2–1mcg/kg/hour). Fentanyl was also prescribed as an IV infusion or IV bolus for analgesic effect. Bolus IV Midazolam may be given if necessary to achieve a desirable level of sedation. Blood pressure was recorded at least every 5 minutes while continuous cardiac, oximeter and capnography monitoring were applied to all patients.Results160 endoscopic procedures were performed in 141 patients (80 males & 61 females), with a mean age of 59.6 ± 19 years old (range 16–93), in this analysis (IDDF2022-ABS-0012 Table 1). Hemodynamic instability (defined as systolic blood pressure <90mmHg and/or heart rate <50bpm) happened in 75 procedures (47%): hypotension alone (24.4%, n=39), bradycardia alone (16.3%, n=26), both hypotension and bradycardia (6.3%, n=10). All hemodynamic instability cases were reversed readily by the following methods: IV fluid challenge and/or reducing Dexmedetomidine infusion rate (88%, n=66), IV Ephedrine (9.3%, n=7) and IV Atropine (2.7%, n=2). Oxygen desaturation (SpO2 85–90%) occurred in 4 cases (2.5%), all of which were corrected successfully by supplementary oxygen. No early termination of procedure due to struggle or sedation-related adverse event was reported. In multivariate analysis, age >65 years old was significantly associated with hemodynamic instability (IDDF2022-ABS-0012 Table 2).Abstract IDDF2022-ABS-0012 Table 1Details of endoscopic procedures (Total number = 160)1. Type of procedures, n (%) Double-ballon enteroscopy (DBE) 57 (35.6%) DBE-assisted endoscopic retrograde cholangiopancreatography 29 (18.1%) Motorized spiral enteroscopy 22 (13.8%) Endoscopic submucosal dissection 52 (32.5%) 2. Procedure time, mean±s.d. (range), min 153.8 ± 84.7 (33–347) 3. Dosage of Dexmedetomidine, mean±s.d., mcg 102 ± 35 4. Dosage of Fentanyl, mean±s.d., mcg 141.5 ± 58.6 5. Procedures with use of Midazolam, n (%) 122 (76.3%) 6. Dosage of Midazolam, mean±s.d.,mg 4 ± 2.1 Abstract IDDF2022-ABS-0012 Table 2Multivariable analysis for independent predictors of hemodynamic instability Odd Ratio 95% Confidence Interval P value Age > 65 years old 1.975 1.353- 2.621 0.036 Male gender 1.212 0.763–1.601 0.227 Use of Dormicum 0.356 0.080–1.581 0.175 Presence of stage 4/5 chronic kidney disease 0.701 0.089–5.525 0.736 Presence of obstructive jaundice/cirrhosis 0.326 0.035–3.026 0.324 Presence of cardiac disease 1.382 0.154–12.424 0.773 Body Mass Index >30kg/m2 1.477 0.124–17.539 0.757 Baseline Mean arterial pressure 0.992 0.978–1.023 0.132 Baseline heart rate 0.986 0.941–1.045 0.317 Use of anti-hypertensive/anti-arrhythmic agents 7.926 0.421–32.721 0.680 ConclusionsDexmedetomidine-based conscious sedation regime is a safe option for prolonged gastrointestinal endoscopy. Cautious use is recommended in the elderly.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><doi>10.1136/gutjnl-2022-IDDF.139</doi></addata></record> |
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| subjects | Analgesics Anesthesia Antihypertensives Atropine Blood pressure Body mass index Bradycardia Carbon dioxide Cardiac arrhythmia Cirrhosis Clinical Gastroenterology Coronary artery disease Dosage Endoscopy Ephedrine Fentanyl Heart diseases Heart rate Hemodynamics Hypotension Instability Intravenous administration Jaundice Kidney diseases Liver cirrhosis Midazolam Multivariate analysis Oxygen Patients Risk factors Titration |
| title | IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy |
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